Prophylactic pentoxifylline and vitamin E use for dental extractions in irradiated head and neck cancer patients: Dental extractions in head & neck radiotherapy

Abstract Objectives : Osteoradionecrosis (ORN) of the jaw is preceded by dental extractions in up to 10% of cases. We present a case series of post-radiotherapy patients undergoing dental extractions receiving prophylactic antifibrotic agents; pentoxifylline and vitamin E (PVe) to prevent ORN. Study Design A retrospective review was conducted of 219 head and neck cancer (HNC) patients undergoing 1079 dental extractions between 2009-2020. Oncological treatment, prophylactic drug regimen, dental history and clinical outcome was collected. Results 12 patients developed ORN at 17 extraction sites (ORN rate: 1.6% & 5.5% at tooth- level patient-level respectively). PVe regimen compliance significantly lowered ORN rates at patient-level (3.4% vs 11.5%, p 40 Gray (p Conclusion PVe regimen compliance lowered dental extraction ORN rates than the literature base rate of 7% at patient-level and 2% at tooth-level. Given its success in managing existing ORN, PVe could be extended prophylactically for dental extractions in irradiated HNC patients.